Mehls O, Schärer K, Michalk D
Monatsschr Kinderheilkd (1902). 1978 Feb;126(2):53-6.
Haematuria in children is either of glomerular or nonglomerular origin. In the latter case intravenous urography should always be performed. A renal biopsy is indicated if unexplained haematuria persists for at least one year or if an unfavorable prognosis is indicated by the appearance of hypertension, significant proteinuria or persistently low levels of serum complement (C3). The importance of screening the families of haematuric patients is emphasized. More than half of our cases with persistent or intermittent haematuria undergoing renal biopsy showed no or only minimal glomerular changes. In other children with a similar clinical picture more severe histological lesions were detected. In any case the kidney tissue obtained by biopsy should be examined by immunofluorescence and by electron microscopy. One of the most frequent causes for persistent or intermittent haematuria during childhood is Berger's disease (IgA/IgG nephropathy).
儿童血尿要么源于肾小球,要么源于非肾小球。在后一种情况下,应始终进行静脉尿路造影。如果不明原因的血尿持续至少一年,或者出现高血压、大量蛋白尿或血清补体(C3)持续低水平提示预后不良,则需要进行肾活检。强调对血尿患者家族进行筛查的重要性。在接受肾活检的持续性或间歇性血尿病例中,超过一半的病例显示无肾小球改变或仅有轻微肾小球改变。在其他具有类似临床表现的儿童中,检测到了更严重的组织学病变。无论如何,通过活检获得的肾组织都应进行免疫荧光和电子显微镜检查。儿童期持续性或间歇性血尿最常见的原因之一是伯杰氏病(IgA/IgG肾病)。